How does WellSpace help fill gaps in
our larger health care system?
I often say we’re really co-dependent.
We’re much less interested in moving into a
space that’s already occupied than filling in
the gaps between. When we started grow-
ing as a Federally Qualified Health Center
we were living in an environment where
there were four islands of health — these
incredible, world-class health systems
(Dignity Health, Kaiser Permanente, Sut-
ter Health and UC Davis Medical Center).
The sea in between was fraught with no
health access. A patient discharged from
one of these hospitals, we used to call it
“walking the plank.” They would leave a
hospital where they had world-class care
to a community where they didn’t have a
provider, they had no access. There’s been
sort of this perverse focus on how the hos-
pitals should somehow take care of the rest
of the universe, and for us it’s been to build
something in the sea in between and then
build bridges and continuity. Imagine a
health delivery continuum, where people
are getting preventive care (and) routine
care, where maybe they’re getting a little
sicker and they’re getting mild to moder-
ate care. Then you get into a realm where
you might need a specialist, or you need a
hospital for acute care. If you build a con-
tinuum and you have the right care-tran-
sition vehicles along that continuum …
from a more acute setting to a less acute
setting, that’s what we’ve tried to do ... for
the low-income population.
We’re not achieving our mission alone,
we’re doing it in partnerships. In Amador
County, we filled in a gap where we’ve
been asked by our local partners to take
commercial insurance because there’s a
lack of health access even for people who
have commercial coverage. So we’ve kind
of ventured into this realm of serving high-
income folks that we’re not used to, and
that’s an example of us being willing to
meet the needs of a community.
WellSpace has undergone a lot of
growth recently, correct?
We’ve grown by a factor of
30 in 10 years, and we’ve done
that because we’ve met a need. When
you hear that we acquired a network
of clinics, (the) clinics have come
and said, ‘Can we fold this into the
network you’re building?’
We’ve grown by a factor of 30 in 10 years,
and we’ve done that because we’ve met a
need. When you hear that we acquired a
network of clinics, (the) clinics have come
and said, “Can we fold this into the net-
work you’re building?” We’ve seen the same
thing on the behavioral-health side, where
some behavioral-health programs have
folded in with us; women’s health, same
thing. So we end up with this entity that
is providing comprehensive services; it’s
not so much predatory, we’re not conquis-
tadors. It’s much more about what is the
need in the community? If you look at the
history of our community, you’ll see there
was nothing for people to go to. ... There’s
not even been a public hospital for (Sacra-
mento), and so we have gone from nothing
to something, and that’s what accounted
for the growth.
How does that growth tie in with the
Affordable Care Act?
We started the growth in 2009, and it was a
pretty steep curve. At that time, there were
between 60,000 and 100,000 people who
had no access to care (in Sacramento Coun-
ty). About 60,000 of those had Medi-Cal but
still didn’t have a place to go. So our initial
strategic initiative was to build a network of
care for people who didn’t have access now.
The Patient Protection and Affordable Care
Act was signed, and that then changed
things. In 2014, we saw a wholesale in-
crease in Medi-Cal beneficiaries. (Sac-
ramento County) went up, within the
October 2019 | comstocksmag.com
29